Reduce an adult patient’s susceptibility to infection during hospitalization

Welp, all the above are good starts, but:

washing hands thoroughly between patient contacts on the parts of ALL CAREGIVERS, to include nurses, doctors, physical therapists, respiratory personnel, etc, (anyone touching a patient)is the NUMBER ONE WAY to reduce nosociomial infections rates, period. NO ifs ands or buts about it.

Well we could always put all our patients on large doses of garlic - that hsould work

Honestly though those are pretty broad topics. To address them properly you have to look at those areas hospitals in general do not do well.

1) We rarely let patients sleep enough
2) diet is often sub-optimal often due to poor appetite, fasting and or absorbtion problems not to mention revolting food
3) Fluid can be a problem even in hospital and there is some convincing evidence that it is definitely a problem in the LTC area.
4) Rest and mobilisation very much depends on motivation and some patients just are not motivated
5) Stress I presume you actually meant reduce stress - again this is personal but a worry of running up bills does not help that problem.

The patient needs to know that it is OK to ask a care provider to wash their hands.

If the patient is stable they should ask the doctor to not schedule them for q 4 hour vitals. We go from room to room with a portable BP cuff that is either machine or manual and also with a thermometer that has the probe cover but is still covered with germs. I can not think of any nurse that disinfects either of these between patients(For those who do, I applaud you).

Having hand sanitizer containers on the wall of each patient room is beneficial and enables staff to at least to sanitize their hands between rooms.

The best way to avoid a nosocomial infection is to avoid the hospital. I have seen more than one "frequent flyer" leave the hospital sicker than when they arrived. It's a shame but it happens.

To prevent nosocomial infection, we practice strict handwashing (before entering the patients's room and after ) on everybody from doctors, nurses, therapists,and visitors especially. On admisson, the family is already informed about handwashing. We're like hawks when visitors come in and we call their attention to it when they don't wash their hands. Everybody just have to be consisitent . We also have hand sanitizers on the wall of each patient room. It has been working because we rarely see our ID doctors.

Unfortunately I believe that most patients will be colonized with microorganisms (some resistant) by the time they leave the hospital (if they aren't already...they are now in the soil in my area...VRE and MRSA). I think most nurses are potentially colonized. The mutants are winning. All we can do is our best, but patients will still unfortunately develop nosocomial infections despite our best efforts. We can't control all links in the chain at the nursing level.

I'm really disillusioned by the 'handwashing saves the day' lines, because the way I see it, we don't operate in sterile conditions, and I don't see all working and living surfaces in our areas being disinfected enough. Would anything be enough today? I wonder sometimes. We can only do so much. Constant gloving and disinfecting of the hands takes it toll...my hands can only take so much.

But we continue to be made to feel guilty because 'we can't wash our hands enough'. I think we're just an easy target.

The problem goes much deeper, IMHO. The public demands abx, the mutants are getting stronger, our patient's are complex and compromised, and facilities (and staff) are not sterile. Just some participants in the problem.

I wish there was some way to clean up the visitors. Amazing how dirty they are when they visit the hospital, how they ignore handwashing signs, how their clothes reek of tobacco and they are visiting an asthmatic, etc. Figure out a way to educate the public BEFORE they come into the hospital.